Dartmouth-Hitchcock nets grant to study peripheral artery disease

Dartmouth-Hitchcock Medical Center will partner with a Boston hospital under a four-year grant to do research on peripheral artery disease to develop effective therapies and reduce the number of patients who need limbs amputated.

“By working together, make discoveries that can be translated into quickly effective therapies for the population to reduce the risk of death and disability from heart and vascular diseases,” Dr. Mark Creager, director of Dartmouth-Hitchcock’s Heart and Vascular Center, said in an interview Monday.

The American Heart Association, where Creager once served as president, has awarded a $3.7 million grant for Dartmouth-Hitchcock and Brigham and Women’s Hospital to form a national center to focus on peripheral artery disease and critical limb ischemia.

“This research will seek to learn what causes critical limb ischemia — severe obstruction of the arteries which markedly reduces blood flow to the extremities (hands, feet and legs) and has progressed to the point of severe pain and skin ulcers or sores,” according to the American Heart Association.

“Researchers will also seek new ways to help identify people at risk by using practical risk tools that could be delivered on a website or phone; and personalize the application of intensive medical therapies to the highest risk patients to reduce the burden of critical limb ischemia and amputation in patients with diabetes,” the association said.

People with peripheral artery disease often feel pain or discomfort in their calf or thigh while walking. People with diabetes are at twice the risk of getting the disease and at six-fold the risk of getting a leg amputated compared to those who don’t have diabetes, Creager said.

The general population is at highest risk for peripheral artery disease at age 65 and over, but patients with diabetes will “get it sooner and they get it more frequently,” Creager said. Peripheral artery disease is not well known to the public, and many doctors don’t know about it either, he said.

Dartmouth-Hitchcock and the Geisel School of Medicine at Dartmouth College will provide “more than a handful, less than a dozen” employees to work on the project, said Creager, who previously worked 31 years at Brigham and Women’s Hospital before leaving in 2015 to join D-H.

Peripheral artery disease affects 8 million to 10 million Americans and more than 200 million people worldwide. Critical limb ischemia probably affects 1 to 2 percent of the peripheral artery disease population, he said.

The United States spends billions of dollars annually on the consequences of the two, including income lost from patients not being able to work, Creager said.

Preventing fewer people from developing critical limb ischemia should lead to a savings in health-care spending, he said.

Researchers hope to determine the molecular mechanisms that lead to the disease’s progression, determine what are the most effective therapies and lastly, “figure out ways to best deliver the most effective care with these therapies with patients with peripheral artery disease and diabetes to prevent the critical limb ischemia from developing,” Creager said.